Single Agent Abraxane as Second Line Therapy in Bladder Cancer

Inclusion Criteria:

* Patients must have histological or cytological diagnosis of urothelial carcinoma. Mixed histologies are permitted as long as transitional cell carcinoma is the major component (i.e. \>50% of the pathologic specimen). Pure or predominant squamous cell carcinomas are not permitted.
* Patients with transitional cell carcinomas of the renal pelvis and ureter are permitted.
* Patients must have metastatic or locally advanced unresectable disease.
* Patients must have received one and only one prior chemotherapeutic regimen which included a platinum (at least one cycle) for metastatic/recurrent disease. Neoadjuvant or adjuvant chemotherapy will be considered to have been first line if the patient progressed within 12 months of the last dose.
* Neoadjuvant/adjuvant chemotherapy (with or without a taxane) is permitted if registration is greater than 12 months since the last dose (patients must then have received one platinum containing regimen in the metastatic setting)
* ECOG performance status \<= 2.
* Estimated life expectancy of \>12 weeks.
* Patients must have measurable disease according to RECIST criteria.
* If female of childbearing potential, pregnancy test is negative within 72 hours priors to first dose of study drug.
* If fertile, patient agrees to use an effective method of contraception to avoid pregnancy for the duration of the study.
* Adequate organ function; Absolute neutrophil count \>1.5 x 109/L. Platelet count \>100 x109/L. Hemoglobin \>90 g/L. Total bilirubin \<1.5x upper limit of normal. Transaminases \<3x upper limit of normal (\<5x if liver metastasis are present) Calculated creatinine clearance \>40 ml/min (Cockcroft \& Gault formula)
* Able to give informed consent.

Exclusion Criteria:

* Prior taxane therapy for metastatic disease (or \> 12 months since a taxane-containing neoadjuvant or adjuvant chemotherapy).
* Pre-existing peripheral neuropathy \>1 by NCI-CTC criteria.
* Pregnant or lactating females.
* Uncontrolled brain or leptomeningeal involvement (treated brain metastasis permitted if both known lesions and medications e.g. steroids for that indication are stable).
* History of serious or concurrent illness that might be aggravated by study treatment.
* History of class II-IV congestive heart failure.
* Other malignancies except adequately controlled basal cell carcinoma of the skin or carcinoma in situ of the cervix or incidental prostate cancer (T1a, Gleason \<7 PSA \<10ng/ml) or any other tumor within 5 years prior to enrollment.
* Other investigational therapy or radiation therapy within 30 days before registration.
* Patients not willing to employ adequate contraception for the duration of the study.